MEDICARE: MS. ROCHELLE DAVIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	376898921097	OH

General Provider Information

NPI Number	:	1760938633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROCHELLE DAVIS

Provider Business Mailing Address
First Line	:	3237 WARREN RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-1149
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3237 WARREN RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-1149
Country	:	US
Telephone Number	:	216-413-7624
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2016
Last Update Date	:	08/30/2016

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